Provider Demographics
NPI:1841429941
Name:MUI, MILLY M (OD)
Entity Type:Individual
Prefix:DR
First Name:MILLY
Middle Name:M
Last Name:MUI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 CENTRE ST
Mailing Address - Street 2:SUITE 722
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4552
Mailing Address - Country:US
Mailing Address - Phone:212-966-3030
Mailing Address - Fax:212-966-3220
Practice Address - Street 1:139 CENTRE ST
Practice Address - Street 2:SUITE 722
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4552
Practice Address - Country:US
Practice Address - Phone:212-966-3030
Practice Address - Fax:212-966-3220
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4770152W00000X
NY007458152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1952744658OtherGROUP NPI NUMBER
NYA100082947OtherMEDICARE PTAN (GROUP)
NY03167186Medicaid
NYA400082952OtherMEDICARE PTAN (INDIVIDUAL)
NYA100082947OtherMEDICARE PTAN (GROUP)
NY1841429941Medicare NSC
NY1952744658OtherGROUP NPI NUMBER
NYA400082952OtherMEDICARE PTAN (INDIVIDUAL)